The American College of Chest Physicians\u00ae\u00a0(CHEST) recently released\u00a0a\u00a0new\u00a0clinical guideline on obstructive sleep apnea (OSA) in pregnancy. Published in the journal\u00a0CHEST\u00ae, the guideline contains nine evidence-based recommendations that provide a trustworthy model for how best to care for pregnant patients with\u00a0OSA.<\/p>\n
OSA is increasingly recognized as being associated with significant morbidity in pregnancy, yet there is minimal guidance available on how best to screen, diagnose, treat, and reevaluate for sleep-disordered breathing (SDB) in pregnant patients. This CHEST guideline was developed to address the need for more specific guidance.<\/p>\n
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What I want most from this guideline is to put sleep-disordered breathing on the radar for pregnant patients and their providers. All too often, symptoms during pregnancy are dismissed as frivolous or temporary, but the reality is that disordered breathing can have\u00a0serious consequences\u00a0both to the parent and the fetus. The guideline also serves as a reminder that not everything goes away postpartum.”<\/p>\n
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Carolyn D’Ambrosio, MD, FCCP, lead author on the guideline<\/p>\n
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According to the guideline, measures of SDB have been associated with adverse fetal growth outcomes, a higher risk of admission to the neonatal intensive care unit at birth, a longer hospital stay, congenital anomalies, and preterm birth.<\/p>\n
Due to\u00a0limited\u00a0available evidence,\u00a0all nine\u00a0conditional\u00a0recommendations\u00a0are noted with\u00a0very low\u00a0level of certainty of evidence.\u00a0Of the\u00a0nine\u00a0recommendations, highlights include:<\/p>\n
\n\tIn pregnant individuals, we suggest screening for SDB.\u00a0
\n\tIn pregnant individuals diagnosed with OSA during pregnancy, we suggest that treatment be based on an AHI 5-15 with symptoms\/sequelae or comorbidity (HTN, stroke, obesity, etc.) or AHI > 15 alone.
\n\tIn postpartum individuals previously diagnosed with OSA during pregnancy, we suggest reassessment for\u00a0SDB.
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The\u00a0entire\u00a0list\u00a0of recommendations\u00a0included in the\u00a0new\u00a0guideline can be accessed through the\u202fCHEST\u202fjournal\u00a0website\u00a0in the article titled,\u00a0“Obstructive Sleep Apnea (OSA) in Pregnancy – An American College of Chest Physicians Clinical Practice Guideline.”<\/p>\n
Source:<\/p>\n
American College of Chest Physicians<\/a><\/p>\n Journal reference:<\/p>\n